Abstract
From 1 January to 30 June 2018, 11 cases of Lymphogranuloma venereum (LGV; all preserved samples (n = 4) genovar L2b) were identified at the Genitourinary Clinic (GUC), Mater Dei Hospital, Msida, Malta. All cases were diagnosed in men who have sex with men (MSM); six participated in three group-sex parties. Here, we describe the outbreak and risk factors associated with LGV diagnoses in MSM in Malta in 2018.
Highlights
From 1 January to 30 June 2018, 11 cases of Lymphogranuloma venereum (LGV; all preserved samples (n = 4) genovar L2b) were identified at the Genitourinary Clinic (GUC), Mater Dei Hospital, Msida, Malta
In March 2018, four men who have sex with men (MSM) sought care at the Genitourinary Clinic (GUC) at Mater Dei Hospital, Msida, Malta as contacts of Chlamydia trachomatis; patients that tested positive for C. trachomatis were subsequently tested for Lymphogranuloma venereum (LGV)
All cases before 2018 were acquired abroad, two cases were epidemiologically linked to LGV positive contacts in the United Kingdom (UK) in 2013 and the Netherlands in 2017, respectively, and the third case likely acquired the infection during a gay cruise in Spain in 2017
Summary
The detection of the first cluster (Ct genovar L2b) and overall increase in LGV diagnoses among MSM in Malta in 2018, coincides with upward trends in other STIs among MSM such as chlamydia, gonorrhoea and syphilis (unpublished data). Cases of LGV are typically notified among HIV-positive MSM who report unprotected anal intercourse, STI co-infection and other high-risk behaviours. Gender identity and intersex protection laws in Malta are of high standard and recent changes in legislation saw the Maltese islands rise to top on the International Lesbian, Gay, Bisexual, Trans and Intersex Association (ILGA)-Europe Rainbow Index in 2016 [11]. This has contributed to make the Maltese Islands an increasingly popular travel destination for MSM. Starting or continuing PrEP in HIV-seronegative MSM engaging in high-risk behaviours is recommended [18]
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